Gait training: Gradual increase in weight bearing (in shoe) starting at 20lbs, increase 20 lbs every 2-3 days over 1 month period to FWB. Joint depression type calc. fracture may hold at 40 lbs for 1 month before progressing.
OK to slow progression if painful. Over the counter orthotic (Spenco, Superfeet) may be helpful.
Begin balance and proprioceptive training.
Wean off assistive device when comfortably FWB with good gait pattern (by 16-17 weeks). Shoe modification if needed.
Home exercise program.
Conditioning: Pool therapy, stationary bike, low impact endurance training. Home exercise program.
Progression of gait, advanced balance and proprioception activities.
Ankle, subtalar isometric, isotonic strengthening with tubing/elastic band resistance (no free weights).
Soft tissue mobilization
Sample exercises for home exercise program:
Progressive calf stretching.
Progressive strengthening using elastic band.
Single leg stance activities.
Foam standing/ wobble board/Baps.
Ankle, subtalar stretching.
Advanced balance & gait training, maximize quality of gait.
Higher impact activities O.K.
Ankle, STJ, strength-endurance training.
Functional assessment: e.g. Timed single leg stance balance and reach, heel raise, squats, step ups.